Kornimate/medical-research-clean huggingface dataset:
avoiding sentinel lymph node biopsy in breast cancer patients after neoadjuvant chemotherapy

Conditions: Breast Cancer; Triple Negative Breast Cancer; HER2-positive Breast Cancer; Sentinel Lymph Node

Summary: this study evaluates whether slnb can safely be omitted in breast cancer patients with her2+ or tn tumors who achieve a radiological complete response on mri after neoadjuvant systemic therapy

axillary staging in clinically node negative (cn0) breast cancer patients with neoadjuvant systemic therapy (nst; i.e. chemo- and immunotherapy), is preferably performed with sentinel lymph node biopsy (slnb) after nst. the probability of a tumor-positive slnb post-nst is low. cn0 patients with human epidermal growth factor receptor 2- positive (her2+) or triple negative (tn) breast cancer who achieve radiologic complete response (rcr) of the breast on mri, have the lowest probability of a tumor-positive slnb post-nst (\<3%). omitting removal of axillary lymph nodes in clinically node negative patients does not increase the rate of distant metastases nor breast cancer mortality. performing slnb can cause short- and long-term morbidity, reducing quality of life. the additional value of performing slnb in patients with a very low risk of tumor-positive axillary lymph nodes should be investigated.

Eligibility criteria:
inclusion criteria: * women, aged ≥ 18 years * invasive her2+ (hr+/-) or tn breast cancer * primary tumor (t), clinical stage t1-3 * neoadjuvant systemic therapy (nst), at least 3 cycles * tumor stage assessed with breast mri before start nst * clinically node-negative before start nst (no suspect alns on ultrasound and fgd-pet/ct, or negative cyto-/histopathology in case of suspect nodes) * mri after or during nst shows radiologic complete response * written and signed informed consent exclusion criteria: * primary tumor (t) clinical stage t4 * patients without ultrasound or fdg-pet/ct pre-nst * history of breast cancer ipsilateral breast * synchronous contralateral breast cancer * synchronous m1 disease

Keywords: neoadjuvant chemotherapy sentinel lymph node biopsy breast cancer complete response
ocular finding in alopecia areata

Conditions: Hair Loss

Summary: alopecia areata (aa) is a common, idiopathic and sometimes recurrent non-scarring type of hair loss. several etiological factors, including psychological, trauma-related, genetic and autoimmune factors have been considered as possible etiological factors . a t cell-mediated autoimmune mechanism in genetically vulnerable individuals is the most acceptable etiology. alopecia areata presents clinically with well demarcated patches of non cicatricial hair loss in any hair bearing area with no remarkable gender preference. although aa may occur at any age, incidence is high among younger age groups. in fact, it is the most common form of alopecia seen in children. various clinical patterns of alopecia have been described as patchy, diffuse, reticulate, ophiasis and ophiasis inversus. depending on the extent of hair loss, it can be classified into alopecia subtotalis, alopecia totalis (complete loss of scalp hair), and alopecia universalis (complete loss of body hair). national alopecia areata foundation has devised "severity of alopecia tool score" (salt score) as a measure of disease severity. scalp is divided into 4 areas, namely, vertex-40% of scalp surface area; right and left profiles-18% each and posterior scalp aspect-24%. salt score is the sum of percentage of hair loss in the above mentioned areas.

alopecia areata is now considered a systemic autoimmune disease that may have other serious comorbidities, such as cardiovascular and ocular. however, the results of studies of ocular findings in aa are controversial. several ocular alterations have been previously reported in patients with aa ranging from minor punctate opacities to cataract. however, there are contrasting opinions on the significance of these lenticular changes. in addition, horner syndrome, pupil ectopia, iris atrophy, fundus changes , bilateral keratoconus, iris changes and retinal changes have been reported in aa. dermoscopy is a noninvasive, diagnostic tool which visualizes subtle patterns of skin lesions not normally visible to the unaided eye. characteristic dermoscopic finding of aa included black dots , tapering hair corresponding to " exclamation mark hairs " , broken hairs , yellow dots , and clustered short vellus hairs ( shorter than 10 mm). since ocular affection can be a profound morbidity factor in patients with aa, we will search deeply in this study about this correlation in order to conclude the value of ocular screening in each and every patient with aa.

Eligibility criteria:
inclusion criteria: * patients of alopecia areata will be recruited from the dermatology outpatients' clinic, assiut university hospitals, assiut, egypt. exclusion criteria: 1. patients with documented eye disease. 2. patients with any systemic illness. 3. patients who received any systemic treatment with possible ocular implications in the last three months.
public's intended uptake and views on organization of esophageal cancer screening

Conditions: Barrett Esophagus; Barrett Adenocarcinoma; Esophageal Adenocarcinoma

Summary: rationale: research on novel methods to screen for esophageal adenocarcinoma (eac) has expanded. insight into individuals' drivers and barriers to attend screening is essential to tailor a potential new screening policy to their preferences. public preferences should also be considered on the organizational level to guarantee client-centered decision-making in the design of the screening process. objective: this study will examine dutch individuals' intended uptake of eac screening, including factors that predict uptake, and their views on its organization. study design: cross-sectional population-based survey. study population: dutch individuals aged 45-75 years. the required sample size is 2088 and 8350 individuals will be invited based on an assumed participation rate of 25%. methods: eligible individuals will be selected from the dutch population registry (brp) using simple random sampling. invitations will be sent by postal mail with participants being directed to a digital survey. main study parameters/endpoints: the primary outcome of the study is the intended uptake of eac screening (strong vs weak). secondary study endpoints are the perceived need for consultation, perceived need for general education campaigns, acceptability of risk stratification scenarios, and acceptability of using health care resources for eac screening. nature and extent of the burden and risks associated with participation, benefit and group relatedness: subjects will not directly benefit from participating in this study. nonetheless, participating in this study is not associated with any healthcare risks and the burden for the subjects is very low. the survey has a low burdensome nature and will take approximately 15 to 20 minutes to complete. all data will be pseudonymized, refusal to fill out the survey or desire to withdraw from the study will not have any consequences for the invited subject.


Eligibility criteria:
inclusion criteria: * aged 45 to 75 years exclusion criteria: * previous diagnosis of eac. * unable to provide informed consent. * unable to fill out the digital survey.
the effect of immunological heterogeneity of tumor microenvironment in the prognosis of gastric cancer

Conditions: Stomach Cancer

Summary: the purpose of this study is to explore the effect of immunological heterogeneity of tumor microenvironment in the short-term outcome and long-term outcome of patients with gastric cancer.

a prospective cohort study will be performed to explore the effect of immunological heterogeneity of tumor microenvironment in the short-term outcome and long-term outcome of patients with gastric cancer. the evaluation parameters are perioperative clinical efficacy, postoperative complications, and 3-year survival and recurrence rates.

Eligibility criteria:
inclusion criteria: 1. age from 18 to 80 years 2. histology confirmed gastric adenocarcinoma (papillary, tubular, mucinous, signet ring cell, or poorly differentiated) confirmed pathologically by endoscopic biopsy. 3. clinical stage: ctnm: stage i or above at preoperative evaluation according to the american joint committee on cancer (ajcc) cancer staging manual eighth edition 4. performance status: eastern cooperative oncology group (ecog) ≤ 2 (normal to symptomatic but in bed less than half the day) 5. clinically fit for gastric cancer surgery, i.e. adequate renal, hepatic, hematologic, and pulmonary function. 6. written informed consent exclusion criteria: 1. women during pregnancy or breast-feeding 2. severe mental disorder 3. history of previous gastrectomy, endoscopic mucosal resection, or endoscopic submucosal dissection 4. history of other malignant diseases within the past five years 5. history of unstable angina or myocardial infarction within the past six months 6. history of a cerebrovascular accident within the past six months 7. history of continuous systematic administration of corticosteroids within one month 8. requirement of simultaneous surgery for other diseases 9. emergency surgery due to complication (bleeding, obstruction, or perforation) caused by gastric cancer 10. forced expiratory volume in 1 second (fev1)\<50% of predicted values 11. inclusion in another clinical trial
eat well live well nutrition program

Conditions: Diabetes or Diabetes Prevention

Summary: the purpose of the study is to develop and evaluate a dietary change program specifically for low-income, african-american women who are at risk for developing diabetes due to obesity. the program uses an innovative approach that emphasizes risk awareness, self-efficacy, and skills training through active learning exercises related to healthy eating. the program is delivered by peer educators in the community and addresses economic and cultural factors that are very important to program participants.


Eligibility criteria:
inclusion criteria: * african-american women * aged 25-55 years * no current diabetes, obese (20% over ideal body weight) * in community neighborhoods
cyclophotocoagulation in glaucoma

Conditions: Glaucoma

Summary: transscleral cyclophotocoagulation of the ciliary body is an effective technique to reduce intraocular pressure in case of glaucoma. due to concerns over complications, the main indications for this second-line treatment are refractory glaucoma medication / surgery and low visual prognosis. the 2000 milliwatts (mw) for 2 seconds settings are used by the majority of researchers and clinicians according to the published literature. some have proposed using 1250 mw for 4 seconds to improve the use of this medical procedure. the aim of this study is to determine how different parameters affect the efficacy of the treatment. this is a prospective double-blinded randomized controlled trial comparing two groups, the experimental group using 1250 mw for 4 seconds and the control group using 2000 mw for 2 seconds.


Eligibility criteria:
inclusion criteria: * patients with poorly controlled high pressure glaucoma * cyclophotocoagulation necessary to prevent visual loss * cyclophotocoagulation necessary to prevent or to reduce ocular discomfort exclusion criteria: * patient has already undergone a cyclophotocoagulation or cryotherapy treatment in the same eye for glaucoma * patients receiving concomitant treatment the same day as the intervention * patient not able to follow the prescribed post-operative treatment
tailored asthma management for urban teens

Conditions: Asthma

Summary: the purpose of this project is to refine and further evaluate an online asthma management and education program for urban teenagers. this project is a continuation of puff city i, a project piloting and evaluating a tailored, school-based, computerized asthma education program for urban teenagers. in this second phase of research, a new version of software (puff city ii) will be created that will target resistance to change and relapse, and using a tested, theory-based approach to student recruitment, conduct a randomized trial to test the efficacy of this new software.

background: teenagers are among an age group that has seen dramatic increases in deaths from asthma. in detroit, asthma death rates for teenagers are high relative to younger ages, despite a higher prevalence in the latter age group. early studies suggest that inadequate asthma management plays a significant role in these grim statistics. design narrative: the study hypothesis is that students randomized to the intervention group will have lower asthma-related morbidity as determined by fewer emergency department visits and hospitalizations at the time of the 12-month follow-up. based on a second hypothesis of better functional status among students randomized to the intervention group, secondary outcomes include fewer symptom-days, symptom-nights, school days missed, and days of restricted activity at the time of the 12-month follow-up. in addition, it is hypothesized that students in the intervention group will have higher scores on the juniper pediatric quality of life scale at 12 months. finally, it is hypothesized that intervention students would exhibit positive changes in adherence behavior, having a rescue inhaler nearby, and smoking at the 12-month follow-up.

Eligibility criteria:
inclusion criteria: * a physician diagnosis of asthma and recent asthma symptoms, health care utilization for asthma, and/or use of medication (or refills of medication) to alleviate asthma symptoms or * no physician diagnosis of asthma and positive responses to items selected from the international study of asthma and allergy in children (isaac) survey and asthma symptoms similar to those used in the expert panel ii for classification of mild intermittent asthma exclusion criteria: * does not meet asthma symptom criteria

Keywords: urban adolescents african american web-based computer tailoring school based
optimal incision site design for lymphaticovenular anastomosis in extremity lymphedema

Conditions: Lymphedema

Summary: our aim was to identify optimal incision sites for lva in extremity lymphedema that would result in the most effective drainage effect for reducing limb edema and enhancing patients' quality of life.

designing the optimal incision sites and identifying functional lymphatic vessels imaging is crucial for success, primarily due to its efficacy in draining edematous lymphatic fluid and reducing swelling in patients with lymphedema. in this study, we conducted patients with lva lymphedema to investigate the correlation between lva incision design, intraoperative functional lymphatic vessel assessment, postoperative limb reduction, and patient satisfaction. question 1：optimal incision site design for lymphaticovenular anastomosis in extremity lymphedema

Eligibility criteria:
inclusion criteria: aged 18-80 years; lymphedema and swelling of the limbs for more than 3 months - exclusion criteria: * lipedema；myoedema
peripheral nerve stimulation registry for intractable migraine headache

Conditions: Intractable Chronic Migraine

Summary: the purpose of this study is to evaluate the long-term safety and performance of neurostimulation for the treatment of intractable chronic migraine as well as to detect infrequent complications or problems only apparent in "real-world" practice


Eligibility criteria:
* patient is 18 years of age or older. * patient has signed and received a copy of the informed consent form; * patient has been implanted with a st. jude medical ce approved implantable neurostimulation system for the treatment of intractable chronic migraine: * patient diagnosed with chronic migraine (15 or more days per month with headache lasting at least 4 hours per day) * patient has failed three or more preventative drugs for treatment of their migraine * patient has at least moderate disability determined using a validated migraine disability instrument \[e.g., midas \>11 or hit-6 \>56\] exclusion criteria: * na
immunoparalysis in acute kidney injury after cardiac surgery

Conditions: Acute Kidney Injury; Immune Deficiency

Summary: infection and sepsis are common after acute kidney injury (aki) and increase mortality. in this study, the investigators will determine whether patients with acute kidney injury after cardiac surgery have immunosuppression as judged by blood markers of immunoparalysis.

immunoparalysis is an immunosuppressed state that occurs after a wide variety of insults including sepsis and cardiopulmonary bypass surgery. due to the impaired infection fighting ability, patients with immunoparalysis are at risk of subsequent infection which can increase mortality. immunoparalysis can be measured by two methods: 1) ex vivo endotoxin stimulation and 2) blood monocyte hla-dr levels. since sepsis is also a known complication of acute kidney injury(aki), the investigators hypothesize that aki is a risk factor for immunoparalysis. the investigators plan to look at these blood factors of immune function from patients before and 3 days following cardiac surgery. urine will also be collected from the patients before their surgery as well as the 3 days following for aki biomarker measurement. this prospective cohort will enroll 300 patients and determine the duration and severity of immunoparalysis among patients who develop aki and those who do not develop aki.

Eligibility criteria:
inclusion criteria: * all adults undergoing cardiac surgery with cpb will be considered for enrollment. exclusion criteria: * factors that affect immune function or aki assessment are the basis for exclusion criteria: * concurrent disease associated with immunosuppression including malignancy, chronic infection (e.g., hiv, hepatitis c), organ transplant and immunosuppressant medications * documented acute infection with the past 1 month (e.g., pneumonia, urinary tract infection) * prednisone or other steroid use currently or within the past one month * aki at the time of surgery * esrd requiring renal replacement therapy * estimated gfr \<45 ml/min (as judged by the chronic kidney disease epidemiology collaboration (ckd-epi) equation
a retrospective analysis of neevo®/neevo®dha compared to a standard prenatal vitamin in anemia during pregnancy

Conditions: Anemia in Pregnancy; Preeclampsia

Summary: this study is a multi-site, retrospective chart review to determine the effect of neevo® or neevo®dha (with higher folate and b12) versus standard prenatal vitamins on hemoglobin (hgb) levels in pregnant women throughout the course of pregnancy. neevo® is a prescription medical food indicated for the dietary management of women under a doctor's care who face high risk pregnancies, older overactive bladder (ob) patients and patients unable to fully metabolize folic acid. data will be collected from existing patient charts of subjects administered neevo® or neevo®dha daily compared to subjects administered a prenatal vitamin daily.


Eligibility criteria:
inclusion criteria: * pregnant females, age 21-39, who received either neevo®/neevo®dha or another standard prenatal vitamin (prenatal vitamins must contain ≤1 mg folic acid, 27-35mg iron, and ≤12mcg vitamin b12). * clinical diagnosis of pregnancy must have been made at ≤12 weeks of pregnancy and on or after january 1, 2008 and delivery must have occurred on or before december 31, 2009. * subjects must have been compliant in taking neevo dha or other prenatal vitamin. exclusion criteria: * subjects should not have taken prenate®, prenate®dha, or prenate® elite, which are l-methylfolate-containing prenatal vitamins. * the following supplements within 2 months prior to randomization; 100mg vitamin c, b12 injection \>10mg of b6; \>32mg iron; \>1.2mg of folate; an l- methylfolate product that is not a prenatal vitamin such as life extension methylfolate, prothera methylfolate, thorne 5-mthf, metanx®, neevo®, neevo®dha, deplin®, cerefolin®, or cerefolinnac®. * history of any anemia other than iron deficiency anemia or leukemia. * blood transfusion in the 4 months prior to diagnosis of pregnancy.

Keywords: neevo neevo dha l-methylfolate anemia during pregnancy folic acid vitamin b12 prenatal vitamins hemoglobin iron deficiency pregnancy
minerals status in relation to overweight and obese adolescent

Conditions: Mineral Deficiency

Summary: evaluation of the concentration of serum mn, se, iron, cu \& zn levels in obese and overweight adolescents, correlate the body composition parameters with these minerals' concentration, study the association between the metabolic risk factors and the disturbance in minerals levels in these patients.

obesity in the population tends to be a notable public health threat on the global scale . individuals with higher body mass index (bmi) are considered to have a lower life expectancy . among the obesity-related indicators, visceral adipose tissue (vat) is acknowledged an emerging and sensitive predictor for the risk of metabolic syndrome and cardiovascular disease . therefore, adverse vat accumulation can influence metabolic health in the population, and its related risk factors should be further investigated. micronutrients in obese people are explored because of an excess energy consumption, and therefore, an inadequate intake of trace elements and minerals. this imbalance among energy consumption and the intake is known as hidden hunger. obesity can lead to nutritional metabolic disorders, in which the general state of trace elements and minerals are altered. only a few studies on child and adolescents obesity concerned trace elements (te). te is involved in the pathogenesis of obesity and obesity related diseases. we tried to assess trace elements status \[ manganese (mn), selenium (se) copper (cu),zinc (zn)\] in obese children and their relationships with vat and metabolic risk factors of obesity. manganese (mn) is an essential trace element . it plays an important role in fat metabolism. selenium (se) is an essential micronutrient that acts as an antioxidant and possesses multiple metabolic properties. copper (cu) is a trace element that is vital. cu has been reported to play a role in fat metabolism. zinc (zn) plays an important role. its deficiency impairs growth, metabolism and immunity. iron (fe) is an essential trace element to sustain all forms of life. existing research indicates iron deficiency is one of the comorbidities associated with obesity .

Eligibility criteria:
inclusion criteria: 1. patients in adolescent age (12-18 years old) 2. patients with bmi over 25. exclusion criteria: 1. patients younger than 12 years old or older than 18 years old. 2. patients with history of chronic use of mineral and /or vitamin supplements . 3. patients with syndromal obesity , endocrine disorder and history of any chronic diseases , 4. patients under special diets or chronic use of medication .
wheezometer® correlation study

Conditions: Asthma; Bronchiolitis

Summary: the primary goal of the study is to more firmly establish correlations between wheezerate(wz%) and other parameters used to assess wheezing and asthma including spirometry, provider's auscultation, and symptoms at the time of wz% measurement.


Eligibility criteria:
inclusion criteria: * patients \<= 12 years of age who have wheezing at the time of study as confirmed by the physicians' auscultation. control: * patients \<= 12 years of age without history of asthma or other pulmonary conditions, and who are without wheezing on physical exam. exclusion criteria: * medical problems that would contraindicate wz% measurement.